Department File Number : | M201679743 |
Claim Number : | 138506 |
Date Submitted : | 9/21/2016 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
MEDICUS INSURANCE COMPANY | Primary | ||||
Insurer FEIN | Professional License Number | ||||
20-5623491 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Dionysia | Lawson | |||
Street Address | |||||
560 Davis Street | |||||
City | State | Zip | |||
San Francisco | CA | 94111 | |||
Phone | Ext | Fax | E-Mail Address | ||
(415) 735 - 2013 | (415) 735 - 2097 | dlawson@norcalmutual.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Thomas | O'Brien | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 1121 N. Central Ave. Ste. B | ||||
City | State | Zip Code | County | ||
Kissimmee | FL | 34741 | Osceola | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
FL-1603016 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME56928 | Internal Medicine - Minor Surgery |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Osceola | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Hospital Inpatient Facility | |||||
Name of Institution | Code | ||||
N/A | 000000 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Patients' Room | |||||
Date of Occurrence | Date Reported to Insurer | ||||
7/21/2013 | 7/17/2014 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Coronary Artery Bypass Graft Procedure | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Thoracentesis | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
*NR | |||||
Principal Injury Giving Rise To The Claim | |||||
Disputed allegation of improper thoracentesis in 50 year old male, post CABG procedure, resulting in cardiac arrest and death. | |||||
Severity Of Injury | |||||
Permanent: Death. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
7/17/2015 | 2015-CA-1708 | ||||
County Suit Filed in | Date of Final Disposition | ||||
Osceola | 3/17/2016 | ||||
Other Defendants Involved in this Claim | |||||
Adventist Health System/Sunbelt Subhani, MD, Noman Pulmonary Disease Specialists Osceola Internal Medicine | |||||
Stage of Legal System at which Settlement was Reached or Award Made | |||||
Within 90 days of suit being filed. | |||||
Final Method of Claim Disposition | |||||
Settled by parties | |||||
Court Decision | Other | ||||
No Court Proceedings. | |||||
Arbitration | |||||
Claim not subject to Arbitration. | |||||
Date of Payment | |||||
4/25/2016 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $225,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $18,788 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $898 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $0 | ||||||||||||||||||||
Deductible | $0 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
| |||||||||||||||||||||
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
Insured met and conferenced with Claims Specialist and Defense Attorney |
Updates | |
No updates found. |
*NR: Prior to 04/28/1999 this field was not required in submitted claims. This page is not displaying certain sensitive information.
Department File Number : | M201987668 |
Claim Number : | 163162 |
Date Submitted : | 1/21/2019 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
NORCAL MUTUAL INSURANCE COMPANY | Primary | ||||
Insurer FEIN | Professional License Number | ||||
94-2301054 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Richard | Petersen | |||
Street Address | |||||
4651 Salisbury Rd. #410 | |||||
City | State | Zip | |||
Jacksonville | FL | 32256 | |||
Phone | Ext | Fax | E-Mail Address | ||
(904) 309 - 8142 | (904) 394 - 7134 | rpetersen@norcal-group.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Thomas | W | O'Brien | ||
Insurer Type | Street Address of Practice | ||||
Licensed | 1121 N. Central Avenue | ||||
City | State | Zip Code | County | ||
Kissimmee | FL | 34741 | Orange | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
719530N | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME56928 | Internal Medicine - No Surgery |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Orange | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Emergency Room | |||||
Name of Institution | Code | ||||
OSCEOLA REGIONAL HOSPITAL | 100110 | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Other | Emergency Room | ||||
Date of Occurrence | Date Reported to Insurer | ||||
7/24/2015 | 5/9/2017 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
On 07/20/15, the patient presented to the ER complaining of right sided chest pain;A chest CTA was performed at the Medical Center & interpreted by co-defendant radiologist which was interpreted as ¿normal"; On 07/24/15, the decedent was seen by Dr. Thomas O¿Brien, pulmonologist;On 07/24/15, the decedent was discharged with the diagnosis of ¿pneumonia of the right lower lobe¿;On 07/27/15, the decedent collapsed at home and he was transported via ambulance back to the ER where he was pronounced dead; the autopsy results confirm the cause of death as ¿bilateral pulmonary thromboemboli due to venous thrombosis¿;A defense standard of care expert reviewed the images and found no Pulmonary Embolism was present. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
On 07/20/15, the patient presented to the ER complaining of right sided chest pain;A chest CTA was performed at the Medical Center & interpreted by co-defendant radiologist which was interpreted as ¿normal"; On 07/24/15, the decedent was seen by Dr. Thomas O¿Brien, pulmonologist;On 07/24/15, the decedent was discharged with the diagnosis of ¿pneumonia of the right lower lobe¿;On 07/27/15, the decedent collapsed at home and he was transported via ambulance back to the ER where he was pronounced dead; the autopsy results confirm the cause of death as ¿bilateral pulmonary thromboemboli due to venous thrombosis¿;A defense standard of care expert reviewed the images and found no Pulmonary Embolism was present. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
*NR | |||||
Principal Injury Giving Rise To The Claim | |||||
On 07/20/15, the patient presented to the ER complaining of right sided chest pain;A chest CTA was performed at the Medical Center & interpreted by co-defendant radiologist which was interpreted as ¿normal"; On 07/24/15, the decedent was seen by Dr. Thomas O¿Brien, pulmonologist;On 07/24/15, the decedent was discharged with the diagnosis of ¿pneumonia of the right lower lobe¿;On 07/27/15, the decedent collapsed at home and he was transported via ambulance back to the ER where he was pronounced dead; the autopsy results confirm the cause of death as ¿bilateral pulmonary thromboemboli due to venous thrombosis¿;A defense standard of care expert reviewed the images and found no Pulmonary Embolism was present. | |||||
Severity Of Injury | |||||
Permanent: Death. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
10/10/2017 | 2017-CA-002372MP | ||||
County Suit Filed in | Date of Final Disposition | ||||
Osceola | 12/28/2018 | ||||
Other Defendants Involved in this Claim | |||||
Stage of Legal System at which Settlement was Reached or Award Made | |||||
More than 90 days, after suit filed and prior to or during the course of mandatory settlement conference. | |||||
Final Method of Claim Disposition | |||||
No Payment Made | |||||
Court Decision | Other | ||||
Other | No Payment Made | ||||
Arbitration | |||||
Claim not subject to Arbitration. | |||||
Date of Payment | |||||
12/28/2018 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | No | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $0 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $12,150 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $0 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $0 | ||||||||||||||||||||
Deductible | $0 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
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Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
Circumstances of the case were discussed with the insured and risk management. |
Updates | |
No updates found. |
Does Dr. THOMAS O'BRIEN, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. THOMAS O'BRIEN, MD has at least 2 medical malpractice case(s), lawsuit(s), or complaint(s).